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Glenn Underwood shops at the Ferry Plaza Farmer's Market on Tuesday, Oct. 10 in San Francisco. Underwood credits his good health to the fresh, organic produce that he purchases twice a week at the farmer's market.

SAN FRANCISCO — Baskets overflow with fresh greens. Tomatoes blush a deep red. The competition for customers’ attention is fierce at the Heirloom Organics farm stand during the lunch-hour rush.

Despite a recent E. coli outbreak, shoppers at this farmers market are reaching with confidence for spinach, reassured that the food is grown nearby, by farmers they can talk to, on land they can visit.

Experts predict that as awareness of farming methods grows, interest in farmers markets, restaurants that buy locally and direct farm-to-consumer sales is bound to grow as well.

“People were scared,” Jaime Smawley said of the tainted spinach linked to one San Juan Bautista packaging plant that killed three people and sickened nearly 200. “They came to us with their questions, but knowing their sources, knowing who we are — that made the difference.”

“I don’t care if it’s pouring down rain, I come every Tuesday,” he said.

The growing importance of this personal connection is evident. The $9 billion organic food market is growing fast — about 20 percent a year — and growers rely increasingly on local customers.

About 79 percent of organic farmers surveyed by the Organic Farming Research Foundation in 2004 were selling their harvests within 100 miles of their farms, with word-of-mouth as their main marketing strategy.

“Farmers markets are growing dramatically, along with community-supported agriculture,” said Bob Scowcroft, the foundation’s executive director, alluding to the direct farm-to-consumer marketing.

Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

“And they’re reporting more sophisticated questions from their consumers,” he said. “Now it’s not just, ‘Do you use pesticides?’ They’re also asking, ’Explain your soil fertility program, where do you get your water from?”’

Era of widespread outbreaksDespite the growing interest in local produce, reliance on produce shipped over long distances has increased. A study by the Leopold Center for Sustainable Agriculture in Iowa found that produce traveled on average more than 1,500 miles to reach Chicago in 1998 — a distance nearly one-fourth longer than in 1981.

But as the recent outbreak revealed, a system that can deliver groceries quickly can also spread fatal bacteria faster, increasing its impact and making it more difficult to trace to its origin.

“We’ve gone from an era when a food-borne outbreak was a potato salad at a church picnic to a multistate, national or even international outbreak affecting thousands,” said Edward Belongia, an epidemiologist with the Infectious Diseases Society of America.

Even farmers say regulating the massive food distribution network is an evolving process for them and the government agencies overseeing it.

“Generally by the time there’s an outbreak, those fields are already plowed under, and when they go back, there’s no way to trace the problem,” said Tom Nunes, president of Nunes Co., which on Sunday recalled more than 8,500 cartons of green leaf lettuce after finding out some of the water used to irrigate the crop had E. coli. On Tuesday, the company announced the bacteria found was not the dangerous variety linked to the Salinas Valley spinach.

The recent spinach outbreak has lead growers and processors to work on a food safety plan they hope to present to the U.S. Food and Drug Administration within days. But even while large-scale producers re-examine their methods, consumers are taking steps of their own, choosing to simplify their relationship to food by placing their trust in the hands of a grower they know.

For about 600 families in California’s San Joaquin Valley, that farmer is Tom Willey, who with his wife, Denesse, runs an organic farm in Madera County. Every week, they pack 600 boxes with a mix of seasonal produce and send them to directly to neighborhoods where customers pick them up.

Twice a year, the Willey’s customers visit their 75-acre farm, where they can see up close how their salad grows.

“They’re taking a chance on me, not on dozens of anonymous farmers they’ll never meet,” Tom Willey said.